The best possible care for your companions
Diesel is well known to the staff at Crown Vets Referrals having been treated early in 2014 for a right forelimb lameness. At this time we used radiographs, joint sampling and arthroscopy to confirm and treat a common elbow condition in large dogs known as Medial Coronoid Disease. This condition occurs due to a number of dynamic and static developmental issues within the elbow joint and results in a fissure fracture or fragmentation of a boney process known as the medial coronoid, resulting in pain and joint inflammation.
This condition can be treated by retrieval of the fragment of bone using arthroscopic surgery. A small camera is inserted in to the joint with images displayed on a flat screen computer monitor. Once the fragment is located it is removed using tiny, specially designed instruments and the joint flushed to remove any debris. The video link shows the surgeons’ view of Diesel’s elbow and shows a small instrument wobbling the bone fragment before removal.
Diesel recovered well from his surgery and his lameness resolved within a few weeks however since this is an issue that can involve both joints it was no surprise to see Diesel back again with an identical lameness in his left elbow in Autumn 2014. He is currently recovering well from his second procedure. Diesel also benefitted from the administration of Autologous Platelet Therapy, a novel cell preparation, which can improve the outlook for dogs with cartilage deficits and arthritis.
Ruby presented to Crown Vets Referrals with a sudden onset lameness in her left hind leg. Examination conscious and under sedation revealed an instability in the stifle joint which is commonly seen following rupture of the Cranial Cruciate Ligament. Radiographs confirmed an abnormal fluid accumulation within the joint known as an effusion, confirming a problem within the joint.
Rupture of the Cranial Cruciate Ligament (CCl) is one of the most common causes of hind limb lameness in dogs. In small dogs restricted exercise and pain relief can occasionally be enough to allow an improvement but larger dogs almost always need surgery to correct the instability. At Crown Vets Referrals we commonly operate to correct this problem and choose a procedure known as Tibial Tuberosity Advancement, an advanced technique, which redirects the forces travelling through and around the joint providing dynamic stability and a rapid return of pain-free function.
The technique involves cutting the tibia (shin bone) and advancing it forward slightly to move the insertion of the quadriceps muscle, neutralising the forces responsible for the instability and pain. The bone is held in its new position using a cleverly engineered titanium wedge through which bone grows to anchor it in place. We also inspected the joint cartilages using arthroscopy to rule out tears or damage. Ruby recovered well in the following 6-8 weeks and is now bounding around the Highlands free of lameness with her very happy owner!
Annie is an adorable and excitable Staffordshire bull terrier. She was referred to Crown Vets Referrals for investigation of bilateral forelimb lameness. We discovered that Annie was suffering from significant elbow arthritis, which was likely due to an underlying developmental problem just like Diesel. Unfortunately Annie’s elbows were causing her a lot of discomfort and had passed a point where arthroscopic surgery could provide a predictable improvement.
Management of osteoarthritis in our family pets has traditionally focused on weight control and exercise modification with appropriate use of anti-inflammatory medication and joint supplements. Recent advances have suggested however that a novel joint cell preparation can provide additional benefits when used in combination with the above. A blood sample is collected from the patient and processed through a special filter system or centrifuge. This system allows us to collect a highly concentrated solution of platelets, which is then injected into the effected joints. Platelets are cells normally found in blood and are responsible for blood clotting. They have however been shown to contain a number of important growth factors and cell signalling molecules, which can provide an anti-inflammatory action and also change the cell environment to support regeneration of cartilage. This technique is known as Autologous Platelet Therapy.
Annie received Autologous Platelet Therapy into both her elbow joints and within a few short weeks her lameness improved dramatically. She is now enjoying a huge improvement in mobility and is back to running rings round her owners!
Millie, was seen at Crown Vets Referrals after an altercation with a car on the A9 near the Kessock Bridge. She was non-weight bearing lame on her left forelimb and had a lot of bruising and swelling near her carpus or wrist joint. Radiographs confirmed an initial suspicion that she had fractured both the radius and ulna making it impossible for her to take her weight on this leg.
We discussed with the owner that fractures of this kind in an animal of Millie’s size and age heal poorly with casting and support bandaging and that a surgical repair would allow a more predictable and faster return to normal function. In this case one good option was to fix the fracture rigidly using a specially engineered metal bone plate and bone screws.
The radiographs below show Millie’s fracture before and after surgery showing the placement of the metal bone plate and screws. Millie is now enjoying a completely normal life and has no functional problems.
Finlay’s owners had noticed that he was finding it difficult to pass faeces and had seen him straining. This can be caused by a huge variety of conditions but when we palpated his abdomen we were able to feel a large very firm abnormal structure in the region of his bladder and prostate gland.
Radiographs and ultrasound imaging of his abdomen revealed an uncommon structure known as a paraprostatic cyst. This is fluid cyst that develops alongside the prostate gland attached by a short communicating tube. The cause of paraprostatic cysts remains a little unclear but it is thought they could develop from a embryological remnant of the female reproductive tract which is found in male dogs and fills with fluid. The cysts can remain asymptomatic for a long time before the animal develops an issue in later life. In Finlay’s case, the cyst was pressing on and occluding his bowel. When the cysts are identified to be causing a problem it likely that surgery is required to remove the cyst and correct the issue.
We performed surgery to resect the paraprostatic cyst. This is an intricate task with extreme care necessary to avoid major structures, nerves and blood vessels, which if disrupted, can cause major complications. Finlay recovered well however and by the time his surgical wound had healed he was once again toileting comfortably.
Murphy came to Crown Vets Referrals as an emergency, having become inappetant and appearing to be in pain. His owners had noticed that he seemed to be walking with a very arched back and had noticed him falling occasionally on his back legs. A clinical and neurological examination suggested this may be due to a problem with his spinal cord.
With the problem getting quickly worse and Murphy losing the use of his back legs, we decided to investigate things a further using a special xray technique called a myelogram. This involves carefully injecting a contrast liquid around the spinal cord which allows us to see any areas where the cord is being compressed and affecting nerve transmission. This confirmed our suspicion that Murphy had a problem with the cushions between the vertebrae called discs, which had burst out of their normal position and were compressing the spinal cord in at least 2 places. This is a very serious problem which in Murphy's case was getting worse, making surgery the only option.
The following day Murphy underwent spinal surgery to relieve points of compression, in a technique known as a hemilaminectomy. We carefully removed the bone from the side of the verterbral canal to create windows over the ruptured discs, delicately removing all the offending material. One week later and Murphy was walking, free of pain with all his neurological function back.
Floss came to see us at CVR with a problem with her waterworks! Her owner was finding lots of wet spots where she was lying and on occasional she would unconsciously dribble urine whilst walking. This was distressing for both her and her owner and so we set about finding out what was happening!
A common condition in young female dogs that can lead to these symptoms, occurs where the tubes from the kidneys - the ureters - bypass the bladder making storage of urine difficult and urine leakage likely. With this in mind we performed some xrays and a CT scan using special dye known as 'contrast'. This contrast enables us to see exactly where all the components of the urinary tract are positioned, making a diagnosis possible.
The CT scan confirmed this was the cause of Floss's problem and allowed us to correct things surgically. The ureters on our image are shown by green arrows bypassing the bladder completely.
Floss underwent a surgical procedure to re-direct her urine flow known as a neoureterocystotomy. This involves making a tiny incision into the bladder wall and ureter and creating a new opening to allow the bladder to fill correctly. This is a very delicate procedure but was performed very successfully. 6 months later and Floss hasn't leaked since. We're happy to report she's back to running up mountains wearing daisy chains on her head!
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